Status of bill

We make every effort to pay or deny bills within 30 days. If, after 30 days, you have not received payment or denial, please complete the form below. A representative will be in contact within 1-3 business days.

W-9 Form

Medical providers must complete a W‐9 form and submit to Synergy Coverage Solutions to receive payment for workers’ compensation claimant invoices. Click here to complete the W‐9 form.

Provider Forms

Essential workers’ compensation Programs

The following key programs are essential to Synergy Coverage Solutions’ workers compensation claims. Our goal is to aid the injured employee to reach maximum medical improvement as quickly as possible.

Early Return to Work / Modified Light Duty

When an employee is injured on the job, our goal is to return the injured worker to productive employment, and a physician’s evaluation plays a critical role. Early Return to Work and Modified Light Duty programs can be utilized to safely return injured employees to work as soon as medically appropriate. When the physician specifies the patient’s capacities and abilities, as well as restrictions, it benefits not only the injured worker, but also their employer.

The forms available below are industry‐specific Transitional Duty Task Lists to indicate tasks that are within the current physical capacities of the employee you are treating. Completed task lists, initialed and signed, should be returned to Synergy Coverage Solutions by email or fax; please also give a copy to the injured worker to hand to their supervisor.

Medications that are deemed inappropriate for the age of the injury or do not meet the medication parameters Synergy has in place will require authorization by the patient’s assigned Claims Adjuster at Synergy Coverage Solutions. Please call 1‐866‐710‐0908 for authorization.